Phencyclidine Use Disorder
DSM-IV In DSM-IV, this is a category called Phencyclidine Use Disorders Disorders # Phencyclidine Dependence # Phencyclidine Abuse DSM-5 Diagnostic Criteria A'''. A pattern of phencyclidine (or a pharmacologically similar substance) use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period: # Phencyclidine is often taken in larger amounts or over a longer period than was intended. # There is a persistent desire or unsuccessful efforts to cut down or control phencyclidine use. # A great deal of time is spent in activities necessary to obtain phencyclidine, use phencyclidine, or recover from its effects. # Craving, or a strong desire or urge to use phencyclidine. # Recurrent phencyclidine use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated absences from work or poor performance related to phencyclidine use; phencyclidine-related absences, suspensions, or expulsions from school; neglect of children or household). # Continued phencyclidine use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of phencyclidine (e.g., arguments with a spouse about consequences of intoxication; physical fights). # Important social, occupational, or recreational activities are given up or reduced because of phencyclidine use. # Recurrent phencyclidine use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by a phencyclidine). # Phencyclidine use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by phencyclidine. # Tolerance, as defined by either of the following: #* '''a. A need for markedly increased amounts of phencyclidine to achieve intoxication or desired effect. #* b'''. A markedly diminished effect with continued use of the same amount of phencyclidine. '''Note: Withdrawal symptoms and signs are not established for phencyclidines, and so this criterion does not apply. (Withdrawal from phencyclidines has been reported in animals but not documented in human users.) Specify if: * In early remission: After full criteria for phencyclidine use disorder were previously met, none of the criteria for phencyclidine use disorder have been met for at least 3 months but for less than 12 months (with the exception that Criterion A4, "Craving, or a strong desire or urge to use phencyclidine," may be met). * In sustained remission: After full criteria for phencyclidine use disorder were previously met, none of the criteria for phencyclidine use disorder have been met at any time during a period of 12 months or longer (with the exception that Criterion A4, "Craving, or a strong desire or urge to use phencyclidine," may be met). Specify if: * In a controlled environment: This additional specifier is used if the individual is in an environment where access to phencyclidine is restricted. Note: If a phencyclidine intoxication or another phencyclidine-induced mental disorder is also present, the comorbid phencyclidine use disorder is indicated in the phencyclidine-induced disorder. For example, if there is comorbid phencyclidine-induced psychotic disorder and phencyclidine use disorder, only the phencyclidine-induced psychotic disorder diagnosis is given, with the recording indicating whether the comorbid phencyclidine use disorder is mild, moderate, or severe (e.g., mild phencyclidine use disorder with phencyclidine-induced psychotic disorder; moderate or severe phencyclidine use disorder with phencyclidine-induced psychotic disorder). Specify current severity: * Mild: Presence of 2-3 symptoms. * Moderate: Presence of 4-5 symptoms. * Severe: Presence of 6 or more symptoms. Specifiers "In a controlled environment" applies as a further specifier of remission if the individual is both in remission and in a controlled environment (i.e., in early remission in a controlled environment or in sustained remission in a controlled environment). Examples of these environments are closely supervised and substance-free jails, therapeutic communities, and locked hospital units. Differential Diagnosis Other substance use disorders Distinguishing the effects of phencyclidine from those of other substances is important, since it may be a common additive to other substances (e.g., cannabis, cocaine). Schizophrenia and other mental disorders Some of the effects of phencyclidine and related substance use may resemble symptoms of other psychiatric disorders, such as psychosis (schizophrenia), low mood (major depressive disorder), violent aggressive behaviors (conduct disorder, antisocial personality disorder). Discerning whether these behaviors occurred before the intake of the drug is important in the differentiation of acute drug effects from preexisting mental disorder. Phencyclidine-induced psychotic disorder should be considered when there is impaired reality testing in individuals experiencing disturbances in perception resulting from ingestion of phencyclidine.